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Health Policy. 2007 Dec;84(2-3):191-9. Epub 2007 Jun 5.

Quality improvement designs are related to the degree of organisation of quality systems: an empirical study of hospital departments.

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Department of Public Health and Caring Sciences, Uppsala Science Park, SE-751 85 Uppsala, Sweden.


Quality systems can help departments do the right things and do things right, but organisation and design need to be considered. The aim was to analyse whether quality systems that include certain quality improvement designs differ with regard to organisational factors and degrees of organisation. A questionnaire was developed and sent to a random sample of 600 hospital departments in Sweden (response rate=75%). A k-means cluster analysis was used to group departments into three degrees of organisation. Analyses of variance were done to study differences in organisational factors and quality improvement designs among the clusters. LISREL analyses were done to study the relationships between organisational factors and quality improvement designs. The results showed that quality systems that included certain quality improvement designs differed with regard to the organisational factors available resources, administration, culture, cooperation, and goal achievement. The results also showed that departments with quality systems of different organisational degrees used different quality improvement designs. Some quality improvement designs may require a quality system with a high degree of organisation to support a successful implementation. The appended questionnaire could be used to plan implementations and evaluate their results.

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